None listed
Conditions
Brief summary
Adults with epilepsy often face memory issues and reduced quality of life despite medical treatments for seizures, with few evidence-based non-drug options available in Australia. This randomised controlled trial tests if the HOBSCOTCH telehealth program (8 weekly sessions of self-management and cognitive strategies) improves quality of life compared to usual care for people living with epilepsy. We hypothesise that completion of the HOBSCOTCH program will result in improvements in quality of life compared to standard care, and will also result in improvements in self-efficacy, mood, and everyday cognitive function in patients with epilepsy. Furthermore, HOBSCOTCH will be feasible and able to be implemented within existing tertiary epilepsy services in Australia. Finally, we predict that HOBSCOTCH is cost-effective.
Interventions
The HOme Based Self-management and COgnitive Training CHanges Lives (HOBSCOTCH) program is an evidence-based self-management program for patients with epilepsy and subjective cognitive concerns. The HOBSCOTCH program comprises 8 weekly 1-hour sessions facilitated by a HOBSCOTCH-trained clinician (‘coach’) to guide participants through memory strategies and problem-solving techniques (i.e., Problem Solving Therapy) according to their own personalised goals. Examples of memory strategies include c
The HOme Based Self-management and COgnitive Training CHanges Lives (HOBSCOTCH) program is an evidence-based self-management program for patients with epilepsy and subjective cognitive concerns. The HOBSCOTCH program comprises 8 weekly 1-hour sessions facilitated by a HOBSCOTCH-trained clinician (‘coach’) to guide participants through memory strategies and problem-solving techniques (i.e., Problem Solving Therapy) according to their own personalised goals. Examples of memory strategies include compensatory techniques (such as routines, reminders or mental associations) as well as lifestyle changes (such as relaxation or managing sleep and fatigue). For this study, HOBSCOTCH coaches will include nursing, psychology and other allied health professionals. All coaches will receive 8 hours of initial training plus an additional 2 hours of re-certification training after two years, delivered by Master Coaches at the HOBSCOTCH Institute for Cognitive Health and Wellbeing. Coaches will be trained or re-certified in the month prior to the first participant enrollment. HOBSCOTCH is delivered via telehealth (phone or video call). Standard care (i.e., treatment as usual) in epilepsy focuses primarily on seizure management and involves periodic reviews with the neurologist/epileptologist. The HOBSCOTCH program differs from standard care as the focus is on improving seizure self-management. Participants will be guided 1:1 through strategies and problem-solving therapy according to a structured program. They will also be provided with a program workbook and encouraged to use a diary to foster self-management with support from their HOBSCOTCH ‘coach’ (i.e., clinician-researcher delivering the intervention). The program workbook is a protected HOBSCOTCH resource available only to participants completing the HOBSCOTCH intervention, and is provided for use in this study by the HOBSCOTCH Institute for Cognitive Health and Wellbeing. Program adherence will be monitored via session attendance records. Intervention Group participants will also have full access to their usual ongoing clinical care with their neurologist/epileptologist, GP, psychologist and/or any other healthcare provider, including medications, psychotherapy, and clinical consultation/review, as individually indicated and arranged outside of the research trial.
Sponsors
Sydney Local Health District
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Patients diagnosed with epilepsy or who have a history of epileptic seizures. • Subjective memory problems or other cognitive concerns. • Aged 18 years or older. • Willingness to provide informed consent, and to participate and comply with the study requirements. • Sufficient English language proficiency to engage in intervention and complete questionnaires.
Exclusion criteria
• Clinically diagnosed progressive neurological disease or dementia. • Acute psychiatric or neurological illness. • Current substance or alcohol misuse. • Individuals experiencing non-epileptic seizures only (in the absence of concurrent epilepsy diagnosis). • Intellectual disability (i.e., IQ<70).
Outcome results
None listed